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新型冠状病毒肺炎全球大流行早期运动医学医生的决策、实践变化及心理健康

Sports Medicine Physician Decision-Making, Practice Changes, and Mental Health During the Early Phase of the SARS-CoV-2 Global Pandemic.

作者信息

Cushman Daniel M, Teramoto Masaru, Babu Ashwin, Olafsen Nathan, Onishi Kentaro, Asay Alexandra, McCormick Zachary L

机构信息

Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah.

Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Sports Medicine Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.

出版信息

Clin J Sport Med. 2022 Jan 1;32(1):28-39. doi: 10.1097/JSM.0000000000000905.

Abstract

OBJECTIVE

The SARS-CoV-2 pandemic has had a profound effect on the healthcare system. This study aimed to identify its effects on sports medicine physicians during the early phase of this pandemic.

DESIGN

Survey study.

SETTING

Sports medicine providers.

PARTICIPANTS

Physician members of the American Medical Society for Sports Medicine were surveyed between March 25 and April 4, 2020. A total of 810 responses were obtained from 2437 physicians who viewed the survey.

INTERVENTIONS

The survey consisted of questions examining demographics, prepandemic practice patterns, anxiety and depression screening, and new beliefs and behaviors following government-based medical policy changes resulting from the pandemic.

MAIN OUTCOME MEASURES

Changes in clinical volume and treatment practices, Patient Health Questionnaire (PHQ-4).

RESULTS

The mean in-person clinic visits reduced to 17.9%, telephone visits to 24.4%, telemedicine (video) visits to 21.8%, and procedural visits to 13.8% of prepandemic practice volume. The mean PHQ-4 scores for physicians were 2.38 ± 2.40. Clinic and procedural volumes were reduced less by male physicians, as well as more experienced physicians, nonphysical medicine and rehabilitation training background, in government or private practice, and in the Southern region of the United States (P < 0.05). Physicians were more likely to reduce their anti-inflammatory (37.8% decreasing vs 6.8% increasing, P < 0.001) and opioid (10.5% vs 6.8%, P = 0.003) prescriptions rather than increase.

CONCLUSIONS

During the early phase of the SARS-COV-2 pandemic sports medicine physicians reported reducing in-person evaluation, management, and procedure volume by over 80%. Multiple demographic and geographic factors were associated with practice volume changes.

摘要

目的

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行对医疗系统产生了深远影响。本研究旨在确定在该大流行早期阶段其对运动医学医生的影响。

设计

调查研究。

地点

运动医学提供者。

参与者

2020年3月25日至4月4日期间对美国运动医学医学会的医生会员进行了调查。从2437名查看该调查的医生中总共获得了810份回复。

干预措施

该调查包括一些问题,涉及人口统计学、大流行前的执业模式、焦虑和抑郁筛查,以及因大流行导致的基于政府的医疗政策变化后的新信念和行为。

主要观察指标

临床量和治疗实践的变化,患者健康问卷(PHQ-4)。

结果

亲自门诊量平均降至大流行前执业量的17.9%,电话门诊量降至24.4%,远程医疗(视频)门诊量降至21.8%,程序性门诊量降至13.8%。医生的平均PHQ-4评分为2.38±2.40。男性医生、经验更丰富的医生、非物理医学与康复培训背景的医生以及在美国南部地区政府或私人执业的医生,其门诊量和程序性门诊量的减少幅度较小(P<0.05)。医生更有可能减少而非增加抗炎药(37.8%减少对6.8%增加,P<0.001)和阿片类药物(10.5%对6.8%,P = 0.003)的处方。

结论

在SARS-CoV-2大流行的早期阶段,运动医学医生报告亲自评估、管理和程序性门诊量减少了80%以上。多种人口统计学和地理因素与执业量变化相关。

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